The patient progresses well. He/she stops using excessive medication and often takes no medication at all. They understand that some of their limitations/pain will be permanent, and they are ready to confront life with that realization.
Their primary physician (typically a surgeon) has released them and given them a reasonable PPD rating.
Suddenly, the patient wants another opinion for purposes of a higher PPD percentage rating. The surgeon, who was well liked, is now denigrated by the patient. The patient suddenly wants social security benefits and catastrophic status, and the key words begin something like this: _this was not my fault and someone has (is going to) pay for this no matter how long I have to wait.
A recent patient had progressed well, was given a 25% PPD, was told that he could function in part time or full time work with restrictions. The patient then began to borrow money from relatives so that he could use _as much time as it takes to make them pay me what I deserve_I talked to one guy, and it took him 15 years, and if it takes me that long, I am willing to wait._
At that point, it is no longer a psychological problem; it is purely a financial one, and further care would be of no assistance.